When it comes to engaging with members, health plans must take culture into account. Culture isn’t just about a person’s race, ethnicity or country of origin. Culture also relates to gender, sexual orientation, age, and physical and cognitive abilities. The U.S. Department of Health and Human Services’ Office of Minority Health has stated that cultural competencies are one of the main ingredients in closing the disparities gap in healthcare.
Behavioral Health and Older Adults
The Substance Abuse and Mental Health Services Administration (SAMHSA) and the Administration for Community Living’s (ACL’s) Administration on Aging (AoA) estimate that as many as 20% of older adults are suffering from one or more mental health or substance abuse conditions. This represents 5.6 to 8 million individuals.
Older adults, however, aren’t a monolithic, homogeneous segment of the population. Within this demographic group, there is a wide variation in terms of racial and ethnic backgrounds, sexual orientation and more. The incidence of behavioral health conditions among these sub-groups also differs. For example:
- The National Institute of Mental Health’s Collaborative Psychiatric Epidemiological Studies data revealed that depressive disorders are significantly higher among older Latinos than in their non-Latino peers.
- This same dataset shows that although older Latinos and African Americans need mental health services, they do not seek these services at the same rates as their Caucasian peers.
- A study of LGBT individuals found that nearly one third (31%) suffered from depression. In addition, older members of the LGBT population have higher rates of depression, suicidal thoughts, and alcohol and tobacco abuse than their peers in the broader population of older adults.
These statistics suggest that health plans must use a cultural lens when determining the best way to engage with older members and connect them with the behavioral health services they need. SAMHSA and AoA advise that culturally adapted messaging around behavioral health services can positively influence the quality of care, as well as service usage among older adults.
Incorporating Cultural Considerations into Interactions with Medicare-Medicaid Members
The Center for Healthcare Strategies reports that younger Medicare-Medicaid beneficiaries (i.e., those under 65) have higher rates of mental health and substance abuse, unstable housing and language barriers. All of these factors can affect member engagement.
Individuals in this group may be dealing with circumstances that affect their ability to participate fully in healthcare obligations. For instance, they may be struggling to feed themselves or their pets, to pay the electricity bill or find transportation to a doctor’s appointment.
Alternatively, it may be difficult for members to connect with health plans by mail or phone. Electronic communications like an SMS text message or face-to-face meetings might be a better approach.
Taking these factors into account can help health plans connect with these members and engage them over the long-term.
Best Practices for Engaging Diverse Member Populations
As health plans develop their member engagement strategies, they may want to consider the following best practices for reaching diverse groups of members:
- Focus on developing approaches that are nonjudgmental and motivational. This is especially important when connecting older adults with behavioral health services, as many people feel there is a stigma associated with mental health issues.
- Empower members and give them a sense of control. For example, health plans should reach out to members about the benefits of preventive care soon after they enroll. Then over time, they can provide them with multiple opportunities to complete health risk assessments and other surveys. This low-pressure approach gives members more control over the process while enabling the health plan to meet any mandatory deadlines.
- Offer different ways to connect that align with the preferences of diverse cultural groups. Older adults may prefer to speak with health plan representatives on the phone, rather than using a computer. For some groups, it may be helpful to offer face-to-face meetings in locations like adult day programs, shelters, libraries or dialysis centers.
- Address barriers to healthcare. Many leading health plans have started to help members with pressing issues that prevent them from getting care, such as transportation to appointments or access to healthy food options. Members who are experiencing socioeconomic barriers to care are less likely to be active participants in managing their health. Through our member outreach and engagement work with health plans, we have found that members who had expressed “concern with meeting basic life necessities” were up to 9% less likely to close preventive care gaps like breast and cervical cancer screenings, than those with no concerns about life necessities.
- Use technology as a force-multiplier to maximize the plan’s reach. Member engagement platforms help health plans target populations and tailor messages to their unique needs. They also offer a variety of communication methodologies that can be matched with member preferences. This increases the likelihood of connecting with and engaging members.
Connecting with diverse members in thoughtful ways can mean the difference between a positive health outcome and a negative one. Research suggests that engaged members are more likely to participate in care planning, finish needs assessments and follow medical advice. This first requires understanding each population’s needs and then reaching out to them in the most appropriate ways.
How are you engaging these diverse member and patient populations?